Vanderbilt Hospital In Nashville Has Nurses Doing Housekeeping

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Vanderbilt University Medical Center’s latest budget moves mean nurses will be responsible for a lot more than patient care.>

The Channel 4 I-Team has learned some Vanderbilt nurses will now be in charge of cleaning patients’ rooms, even bathrooms.

Sanitized environments in hospitals are critical to a patient’s health, but the new cost cutting measure has at least one nurse concerned.

“Cleaning the room after the case, including pulling your trash and mopping the floor, are all infection-prevention strategies. And it’s all nursing, and it’s all surgical tech. You may not believe that, but even Florence Nightingale knew that was true,” said a hospital administrator to staff in a video obtained by the Channel 4 I-Team.

The new cleaning changes were also detailed in an email sent to staff of the Vanderbilt Medical Center East team, which – according to a hospital employee – works in surgery areas and patient rooms.

A manager writes in the email, “We have undergone some major budgetary changes … this means we will need to pull together like never before.”

The email says nurses will now have to pull their own trash and linens, sweep up and spot mop. Nurses, care partners and nursing assistants will be responsible for all patient care areas.

“The priority will be what the patient sees,” the email states.

Also, in bold highlighted text, the email says, “Be sure to wear the appropriate [personal protective equipment] when doing any disinfecting – that includes, a cover up gown, gloves, mask and even an eye shield when necessary.”

Nurses were also told to “refrain from speaking negatively about this in an open forum where our customer can hear. If you need to vent come see me.”

The hospital employee did not want to be identified for fear of losing her job but wanted the public to be aware of the changes.

“This is our new reality. The work still must be done. We must still care for patients, and we must do so in an efficient manner,” the hospital administrator told staff in the video obtained by the Channel 4 I-Team.

The nurse to whom we spoke says before these changes, the hospital’s environmental services department was in charge of cleaning those patient areas and that staff does not have interaction with patients.

The nurse is concerned that doing both cleaning and patient care could lead to cross contamination.

The email obtained by the Channel 4 I-Team does say environmental services will still be handling some cleaning.

In a statement, Assistant Vice Chancellor John Howser, said:

“The safety of our patients is always of foremost concern. All decisions about operational process redesign at the Medical Center are being made in a patient-centric manner and will not affect the safety of patient care.”

The Tennessee Department of Health says it does not specify how a hospital chooses to clean, as long as the employees are appropriately trained and follow CDC guidelines.

If they do that, the state says there should not be any increased risk of infection.

We checked with Lipscomb’s nursing staff. The executive associate dean of nursing, who has been a nurse for 25 years, says she hasn’t heard of a hospital doing this before.

Copyright 2013 WSMV (Meredith Corporation). All rights reserved.

This really bothers me. As nurses, we already have hundreds of responsibilities, and I believe Vanderbilt’s choice to have nurses clean toilets and mop floors may lead to cross contamination as well as an increase in patient falls and medical errors. I am certain they are not going to decrease the nurse:patient ratio in order to make this change easier on the nurses. Vanderbilt is looking for ways to slash jobs, so they are getting rid of EVS because they can only legally get rid of so many nurses.

Especially insulting is the implication that Florence Nightingale would have wanted nurses to return to doing housekeeping in the hospital. Nightingale wanted nursing to move forward, not backward.

Please help me get this out on social media! Retweet, reblog. Post it on Facebook. Don’t let Vanderbilt harm patients and nurses this way! Use the #Vanderbilt hashtag.

About Grimalkin, RN

Trying really hard to be a decent person. Registered Nurse. Intersectional Feminism. Poet. Cat. Political. Original recipes. Original Stories. Occasionally Questionable Judgement. Creator of #cookingwithjoanne and #stopcock. Soulless Unwashed Carrot. This blog is dedicated to my grandmother, my beloved cat Grimalkin, and my patients.

Posted on September 16, 2013, in Nursing and tagged , , , . Bookmark the permalink. 185 Comments.

  1. Thank you for covering this issue 🙂 We’re tagging what we find and posting it here 🙂

  2. What has our world come to? I think having nurses cleaning rooms is ridiculous. It is not beneath a nurse to clean but we have close contact with patients. There is going to be cross contamination. The health department can’t tell hospitals how to do their cleaning but they could mandate the hospital the type of personnel that is permitted to do the cleaning. Let’s wait until someone gets sick from cross contamination before anyone does anything about this situation. I would think that it would be more expensive supplying staff with the “appropriate” apparel to do the cleaning. It certainly is going to cost the hospital a lot more when someone sues the hospital because their loved one got sick from a nurse who followed the protocol put in place for cleaning rooms and the loved one does not recover. Shame on Vanderbilt University Medical Center.

  3. That is really a brilliant “Six Sigma” way to maximize the productivity NOT. I mean, How much does a janitor gets paid an hour? How much does a RN gets paid an hour? What is up with Vanderbilt “Management”? What is the Nurse Director doing? Just saying: “Yes” to all management says. Is the Nursing Director forgetting that nurses are the liaison between healthcare system and the ill client? Not between the client and the mop? Management fail to see what is the business, nurses DO ADD VALUE to the hospital. Clients go there for NURSING care, if they just wanted to see their MDs the clients would go to their MDs offices, but once in the hospital the added value is the 24 hrs NURSING care.

  4. I really love this blog! It’s everything I try n tell my husband everyday! He’s a mechanic and works M-F 8-5 and he always says to me ” how hard can it be to give meds and your paper work” or ” why are you so tired you had a easy night” I tell him he just don’t understand. I really like how you put only nurses understand. It’s true! I’m glad I have off the next to days bc after Sunday night I am ready!!!

  5. This is being done in New Jersey! Or nurses and scrub techs are expected to do the housekeeping !


  7. I am floored that Vanderbilt is implementing this change in housekeeping duties. I have no problem emptying a trash can, but to tell me that along with all the other things I do for my patients, I’m now responsible for 6-8 patients, and all the housekeeping duties that go along with those patients, astounds me. Just exactly when am I supposed to add that into my 12 hour shift?? There are nurses everywhere who often stay past their shift, to finish charting because they have been too busy with patient care to get it done. Just what exactly does the management “genius” that came up with this idea, think nurses do all day?? Last time I checked, most nurses forgo more meals then they get, go for hours without sitting down, and consider yourself lucky if you get to go to the bathroom once during your shift because you are so busy! Why don’t those idiots in upper management come down to the floor and scrub a few toiles, and let nurses do their job, yanno, the patient care, giving meds, making sure people don’t die job that they were initially hired for. If I wanted to be a housekeeper, I wouldn’t have gone to college to become a nurse.

  8. I am an RN and I do a great job, but my degree will never be used for housekeeping! Cut your budget, cause I would quit your hospital!

  9. Wow…I don’t even know what to say. I AM one of those nurses that stays late charting or just trying to finish up. I ate lunch between 3:30 and 4 pm my last two shifts and even then I was charting while eating. I am sure we have all done the initial cleaning up of a room or bathroom after a “code brown” situation but to actually CLEAN like the EVS does….whew. Are patients and family members going to understand why I won’t be available to get them to the bathroom or give them pain medicine because I was mopping another patient’s bathroom floor? I seriously doubt it. This is just getting to be ridiculous. I already have concerns about staying in this field just due to the regular getting old stuff like arthritis in my lower back and now one of my knees. These twelve hour shifts just keep getting harder and harder but if I have to clean up patients’ rooms…I don’t know. Where am I supposed to find the extra time?

  10. I agree with all of you. Adding additional tasks to nursing is dangerous. Pt acuity and ratios are too high to add more for the nurse to do. Cross-contamination is less of a risk because nurses care for their pts and will do a great job of preventing this. The problem is that they will be busy performing tasks when they should be monitoring their pts. Patients will be at greater risk.

    Lets make sure not to downgrade importance of EVS staff. They are hard workers, under paid, under appreciated. They are a critical part of the healthcare system. If they don’t do their job well…. no matter what WE do as clinicians, patients can be adversely affected.

  11. Really? Is Vanderbilt a ‘magnet’ hospital? The filth in hospitals is already the cause of soaring rates of infection. Reducing cleaning staff? Right! Because the nurses just sit around and party now.
    Cone on nurses, grow some. What next? Is this why everyone needs a BSN?

  12. Lol, patient-centric?

  13. I work in a Ed and we clean rooms! We laugh at all we do ! We clean, we make the beds, we clean the bathrooms, transport, we do all the ekgs, breathing treatments, we have to break charts down and file ( stuff HUC’s usually do) we page and contact our docs, we put on the the ocl’s , we collect co- pays …much more but I would go on for ever! We all joke that we don’t get to be nurses much anymore!

  14. Thanks for sharing this….nurses must stay on top of situations like this and pay attention to the politics of it all…..even though most nurses just would like to take care of patients, the future will require that nurses learn so much more about the health care system. Be informed, get the facts and pay attention to health care happenings. In a time when jobs are needed….this seems to be an odd move.

  15. I can’t wait to retire – 3 more years…I have to wait for age 66 to have health insurance since we don’t have anything like health benefits even after 44 years in the hospital setting! I can just see the scenario – you are all gowned up and cleaning a room when a patient that needed you fell or coded. Now nurses have to treat the computer (our charting is horrendous since they added all the insurance and government requirements we have to chart on to get paid), it’s slow, it goes down and is unsafe; babysit the new residents to make sure they haven’t killed anyone; deal with doctors that throw fits because their case was canceled that was schedule for 4 hours and their next patient isn’t ready for OR or not even in the hospital yet; do general maintenance to keep equipment working since there isn’t anyone to service them until you make out a work order and they’ll see you in a few days; deal with families and patients who feel they are at the Hilton and making ridiculous requests (they don’t understand why they can’t go into the recovery room or OR with their loved one); asking for lobster and steak dinners at 11:30 at night, etc. It’s too bad nursing isn’t nursing anymore, I miss it….

  16. omg! How ridiculous? The person who thought of this ridiculous idea should be fired. I wouldn’t want to be cared for after my nurse have just scrubbed the toilet. If I wouldn’t mind, may be I wouldn’t mind to be taken care by the house keeper. Perhaps the hospital should fired all the nurses and have the house keeper take care of the patients. They can save more money! If this is what this hospital came up with, who know what else they have cut in order increase their profits? I would question everything else that goes on at this hospital. Urgh! How disgusting? Yuck!

  17. I’m left without words. After being a critical care nurse for 23 years, my heart that was my job is broken. I so want to fight to protect who we are as a profession, but I’m afraid I’ve lost hope. The reward of a grateful patient and family used to be enough in these changing times, but I’m losing hope. I bet that son of a bitch CEO didn’t take a pay cut in these hard times, and I’m damn sure he does NOT empty his trash!

    • I have always believed that CEO down to supervisors get bonuses when we work understaffed. The honchos in a ‘non-profit’ make big bucks and there are so many underemployed nurses that they feel they can do what they want
      We need to rebel

      • And you are correct. The money that they save goes into bonuses. Its sickening.
        I’ve been saying for awhile that Nurses have got to stand together and fight this nonsense for the sake of our patients if not for ourselves. We all know already how this is negatively affecting patient care. We do the best we can but instead of hospitals being pleased with our work, they use it as a way to make even more cuts at the bedside so they can continue to rake in the big bucks and bonuses that healthcare is affording them. I’m sad to be part of such a system, and truly only stay in it because I love my patients.

  18. Unionize. Stage a walk-out. Blacken their name on social and mainstream media. Petition. Shame them into ferreting out the root cause of their financial mismanagement. Deliver gift baskets of cleaning supplies to administration suite. Demand town hall-type open forum. Present evidence-based practices which counter their assertions. Have a dress and practice like Florence Nightingale day – no electronics and modern treatments or like a chambermaid – skulk about without making eye contact or conversation with anyone. Fight back, Vanderbilt nurses! We’re behind you!

  19. concernednurse101

    Nurses in tn stand up!! Its time for the labor force in Nashville to organize and let management know they can’t do whatever they please and staff just has to deal with it. While you are at it demand this administrator be fired without a huge package that would equate to 100yrs worth of EVS salary. Nurses you can band together and make a difference or they will pick you off one at a time while putting the blame on you. Don’t let this fear driven gag order by some out of touch manager keep you from standing up for yourselves. TN needs this and the nursing profession needs you to stand together.

  20. This is crazy. All the things nurses have to do now housekeeping!! Do they cut the number of pts nurses have? Doubt it. We already have to be unit sec putting in our orders, drawing blood for labs, EKG tech, respiratory tech now housekeeping??!!! I would quit there!!

  21. I have worked in small hospitals where the OR team was expected to clean rooms. But in a hospital with a case load as big as Vanderbilt, they will see an increase in turnover times. This will lead to surgeon dissatisfaction and loss of revenue. They are not making any money during turnover time. Some mental midget hospital administrator with insufficient experience has come up with this idea.

  22. As a former nurse educator having taught in a ADN program, I wonder what the impact will be on future college students considering nursing as their profession.
    Let’s see….
    RN education $30,000 – $80,000 which for which the graduate receives a college diploma and the opportunity to take a national licensure exam. Upon successful passing of the NCLEX, the graduate now receives a nursing license and the opportunity to earn a RN salary. Without gaining licensure, the graduate is the owner of a diploma only with no earning power.
    Prospective college students look at educational cost vs. employment satisfaction & salary as guiding points to choosing a career. Nursing is no exception. Yes it can be a calling and the road to obtaining the education a fulfilling journey, however the end goal is the same – the ability to do something one is passionate about for a reasonable salary.
    Think carefully for a minute. A licensed nurse is liable for the care provided or not provided to a patient. Does any nurse want to cause harm to a patient? Does any nurse want to loose their license to practice due to being occupied performing “other duties as assigned” that do not relate to the State scope of practice for the RN or LPN?

    How will Vanderbilt’s decision affect it’s nursing program admission rates? Time will tell.
    How will this decision affect all the indicators of a quality facility? Time will tell.
    How will Vanderbilt’s reputation be maintained? Time will tell.

    One thing that is known now is that the value of a nurse is in question.
    In a time where the IOM and ANA are stressing the need for increased numbers of nurses to meet the increasing care needs of a burgeoning senior population, how can this decision do anything but make a college student question the true value of a nurse? Practicing nurses may question the value of pursuing a BSN degree. Nurse researchers will once again be working toward proving the cost/benefit ratio of the RN and LPN to justify staffing ratios.

    Perhaps it is time for nurses to become the leaders of change instead of the recipients of questionable decisions that impact our profession.

  23. I go in and change beds, clear bedside tables for meals..wipe butts, pass meds, but I will not..I will not…mop floors….after 24 years of RNing….I am sorry but that is not going to happen in my world….this is going to blow up in their face…just watch!!

  24. Most RNs still scrub bedpans. Adding floor and bed cleaning to a busy day/night is beyond the call of duty. Where is the combat pay?

  25. Nurses doing housekeeping? On a regular basis? Same nurse taking care of patients? OMG!! That sounds like a good way to get your patients worse rather than better. I can understand the attending nurse cleaning up after a patient “accident”, but regular housekeeping to boot, scares the h*** out of me as a prospective patient.

  26. Renee Belsha

    2 minutes ago

    They would assign nurses at VA to clean the shower area amongst other things..guess what the result was?? Dirty bathrooms they all shared.  there isn’t enough time in a day to take good care of the patients. What idiot came up with this??

    Vanderbilt Hospital In Nashville to Have Nurses Doing HousekeepingSource here NASHVILLE, TN (WSMV) – Vanderbilt University Medical Center’s latest budget moves mean nurses will be responsible for a lot more than patient care.> The Channel 4 I-Team has learned …


  27. If Vanderbilt doesn’t have a union, they need one. My mother was so proud to see me become a nurse almost 39 yrs. ago. Wouldn’t she love to see me cleaning rooms. Isn’t it enough that we clean up human waste? Very demoralizing. I would quit before I would do it. As I said when I left one job, “Don’t you know there is a nursing shortage? I can go somewhere else and receive better treatment.” Nurses by nature are co-dependant, No one can treat you in a way that you don’t deserve unless
    you allow it. No job is worth this.

  28. EMS has to decon their stretcher, equipment and truck after every patient, join the club!

    • that comment is irrelevant. This is about RNs in a hospiotal with many more than 1 patient at a time….

  29. I have been a nurse for close to 30 years and what I just read is appalling. Nurses are expected to do more and more with less help. More errors are being made and more nurses are burnt out.
    It is probably a CHS owned hospital which is a for profit compsny. They care more about padding their stock holder pockets than Safe patient care.

  30. Tulane university hospital ER has nurses clean the rooms. The EVS staff is instructed to not make the bed. The EVS staff is “suppose to” mop floors and dust things and clean bathrooms. The nurses clean up bodily fluids, beds, empty trash cans and also change light bulbs in exam equipment and when EVS doesn’t show up do their jobs. We have even gone to the floor to clean med/surg beds in order to move admitted patients out of the ER.
    This Vanderbilt article is of no shock to me. Welcome to nursing in the new millennium

    • Come on Ladies and Gents
      You are educated professionals
      Imagine an accountant or the Pharmacist
      Or a doctor- pulling together and doing more with less
      Together we’d be strong

  31. I keep thinking the source of this article is The Onion. Handmaiden lives on. I’ll be shocked if the nurses do little more than martyr themselves because it is the nursing way. Maybe this will be the one issue that gets all nurses to unite.

    • Right on

    • And this is exactly why these hospitals are doing this and getting away with it. I have left more than one hospital that made ridiculous demands like this. We must all be prepared to stand up for ourselves and our patients. Hospital greed is getting out of control.


    • Little difference there EMS person, you will have time to do just that most of the time before the next run., also you r not nurses most of the time .Please no unions we can do this without some one telling US what to do, who knows maybe this is part of Obama care

  33. And until we get unions for nurses in all states, these things will continue to happen. Next they will have nurses washing the linens and cooking. Disgusting. What is that pig administrator smoking? I guarantee you he is not having to stretch himself like those nurses are. I also guarantee you he will not see one thin dime cut from his multi-million dollar salary. I hope they all walk out on him.

  34. Unionize!!!!! Walk out! Make that jerk regret this stupid decision!

  35. I just retired from nursing after 34 years at the bedside. We used to laugh about the “standards of nursing ca 1914 where the nurse was responsible to trim the pen nips, stoke the furnace, etc”. Seems like we’re going back to that. I don’t think patients or family will understand when I can’t take care of them because I’m cleaning a toilet or mopping a floor. We used to strip the beds when a patient was discharged to help with room turnover, and to work as a team with EVS. I have no objection to that, but taking over EVS services is another thing. Nursing with 12 hour shifts is a physically, emotionally tiring job and I’m glad I’m done.

  36. Nursing is just getting more and more ridiculous! And, don’t think the high cost of healthcare will go to pay those nurses more. It pads the pockets of healthcare administrators and drug companies…not the staff doing the work. Think about your patient scores now when they can’t get what they need because the nurse is cleaning toilets. I’ve been a registered nurse for over 40 years and am glad I am retiring in 10 months. I would never recommend anybody going into nursing unless they plan to stay in school and go for their CRNA or nurse prac. degrees. This is totally demeaning to anybody who has gone through nursing school, whether it be diploma, ADN, or BSN, have taken boards and is considered a professional. All Vanderbilt and other facilities who do this are thinking about is the bottom line….not their employees or their patients.

  37. Love4nursing89

    I have been a critical care nurse for 25 years and never minded doing some of the housekeeping little things to keep things picked up and everything in order. So many ideals or assumptions are based upon what visitors see when they first walk into the room. To expect nurses to find time to actually assume the full cleaning of room after a case is ridiculous and a waste of nursing hours. I am not above doing anything that will help with the care of my patients. So I have to clean a room after I transfer my patient out, before I can take an admission that has been waiting for an ICU bed for 5 hours in the ER. Instead of preparing for the patient, IV’s, meds, etc I am focused in on cleaning. Need I say more?

  38. A better way to handle the crises might be to dock the CEO’s pay for an hour or two a week and use the proceeds to hire a dozen housekeepers for a month.
    We all have to pull together to hang on to our coveted position as most expensive and17th best healthcare system in the World!
    Don’t blame Obama
    Blame Greed

  39. Uh,, yeah,,, a union and more BSN high heeled nurses are just what we need,,,, i’d rather mop floors than pay union dues for some fatcat union boss to get rich and send my dues to Democrat politicians to buy votes or another paper producing BSN making MORE work for us worker bees walking around in a labcoat providing no pt care,, just producing paper. And i’ve been a proud Operating Room Nurse in cardiovascular surgery for 40 years.

  40. Please no unions I agree with Mike however I do not think having a BSN has anything to do with this .. I am still working with one and I know I am alot older than all of you…We need to stick together not throw darts @ one another……

    • Kaycarroll1919

      I brought up BSNs not to divide, no difference, it just that a BSN is becoming an entry level demand, esp in magnet hospitals.
      The other professionals in the hospital pharmacy, medicine, what have you, aren’t cleaning, that’s my comparison.
      I would never throw darts at a nurse-have been an aide, Lpn, RN, BSN.

  41. I have worked at hospitals and ASC’s all over the east coast and in the as aspect we did it all anyway with a 10 minute turnover. There were no resource staff to clean your rooms. You did it all scrubs and nurses worked together to turn over the room. It makes for a hectic day but in the end you know you are the only one responsible for disinfecting your room. You dont have several different people coming in and maybe cutting corners to get a faster turnover number. Just my two cents.

    • Just curious what the patient load was and the acuity of care? Many units have 30 plus beds with one or 2 techs and the nurse is responsible for 6 patients.

  42. It does not take a lot of words to say this idea is from a stupid mind and should be rescinded.

  43. Wow, and he uses Florence Nightingale to justify his decision. That’s amazing! I am sure his concept of pulling together does not include additional responsibilities for the physicians and administrative staff. Paying a nurse $25 an hour to clean rather than a housekeeper $10 seems a bit nonsensical. I know we all pick up in our patients rooms and want to give the best care possible. However, the lines have been blurred beyond recognition. We are educated, respectable employees that know the difference in taking care of a patient and being taken advantage of. When will they understand, we as nurses need to have time to review medications, labs, radiology reports, and doctors notes in order to provide optimal care. Often we are the first to see an error or a change in status. How will we see our patients if we are looking down in a mop bucket.

  44. What in the name are these people thinking with this idea??? Let’s have the Doctor’s join in the fun and have them wear their surgical scrubs (mind you, they must wear their PPE, as well) right before they preform open heart surgery.

    The hospital CEOs can join us with their suits and dresses on, all in the name of cutting costs.

    Oh I know, as a pediatric RN for 20 plus years, I’ll mop the floor, clean the toilets, of course wash my hands properly, but in the next instant go feed the crying baby next door, change their PICC line dressing, and start some IV meds…..

    What could possibly go wrong???

  45. Sorry. My patient just have to wait. I can not do CPR right now and cannot save him- I’M CLEANING THE TOILET BOWL OF ANOTHER PATIENT!!!!!

  46. Its all the bottom line!! Pile more and more on the nurse, you can get rid of a housekeeping person. I agree, this is going backwards from what old Florence herself would have wanted. It will come back to bite them (adm.) in the gluteus.

  47. I hate to say I am not surprised to hear this. Nurses are expected to fill in for everyone whose job they can cut. While we have all had to help clean under some circumstances, this should not be the norm.
    I can only hope that If a patient is coding the nurse will be available to grab the crash cart, push drugs , bag the patient etc instead of looking for a mop or a brush to clean the toilet. Or since our jobs are interchangeable with housekeeping, maybe they can start CPR while I finish changing the dirty water in the pail.
    I can’t advise any younger nurse to stay in nursing. After 35 years in the profession , I am happy to be on the way out. You can be sure if I have a family member in any hospital I will be commenting to administration if I see the nurse mopping then giving meds .
    Btw, is the administrator cleaning his own office? Doubt it

  48. Rebecca Mullins, RN, FNP-C, DNP

    Maybe they can get security or a parking lot attendant to start IVs!

  49. Absolutely unequivocally ridiculous including pathetic and dangerous. Nurses are over worked as it is with patient care and to expect them to santitize clean FORGET IT. Patients are at jeopardy already with all these budget cuts. Ask how many chiefs do we need leave the Indians ALONE

  50. So do the doctors help and with the extra work with no cleaning staff for the rooms do they get extra money?

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